The impact of ‘Shahal’ (a new cardiac emergency service) on subscribers' requests for medical assistance: characteristics and distribution of calls

The objectives of this study were to assess the impact of the new ‘Shahal’ (pre-hospital cardiac service) on subscribers' ‘decision time’. A professional 24-h mobile emergency cardiac service has been set up, monitored by intensive care nurses via a central computerized operation unit. All subscribers carry a cardiobeeper for trans-telephonic transmission of a 3-lead electrocardiogram as well as an automatic intramuscular lidocaine injector for self-injection. During a 1-year period, data from 10 304 subscribers' charts were reviewed and analysed. Seventy-nine percent were cardiac patients and 15% were completely healthy. Median decision time for the general population was 44 min (range <15 min to <3 h); 59% of subscribers called within 1 h from onset of symptoms and 29% delayed calling for 3 h and more. The healthy subjects alerted the service significantly earlier (29 min). Three patterns of behaviour emerged from analysis of the daily distribution of calls.